Epidemiological evidence suggests that size at birth may affect health in later life. The growth of the fetus may be adversely affected by a suboptimal maternal environment. Understanding placental development and function will help unravel the mechanisms controlling fetal growth. This article poses the problem: how does the maternal environment (uterine or systemic) influence placental development? Critical human placental functions include remodelling maternal uterine spiral arteries to increase the flow of blood to the maternofetal interface, and transferring oxygen and nutrients into the fetal vasculature, all processes involving trophoblast. Gene ablations that affect pregnancy outcome in mice lead to some interesting hypotheses.